WO2012052582A2 - Moniteur multimodal portable, conçu pour des êtres humains, basé sur un avatar biomécanico-physiologique pour la détection d'événements physiques à risque - Google Patents

Moniteur multimodal portable, conçu pour des êtres humains, basé sur un avatar biomécanico-physiologique pour la détection d'événements physiques à risque Download PDF

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Publication number
WO2012052582A2
WO2012052582A2 PCT/ES2011/000311 ES2011000311W WO2012052582A2 WO 2012052582 A2 WO2012052582 A2 WO 2012052582A2 ES 2011000311 W ES2011000311 W ES 2011000311W WO 2012052582 A2 WO2012052582 A2 WO 2012052582A2
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WIPO (PCT)
Prior art keywords
biomechanical
physiological
subject
avatar
portable
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PCT/ES2011/000311
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English (en)
Spanish (es)
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WO2012052582A3 (fr
Inventor
Manuel Prado Velasco
Rafael ORTIZ MARÍN
María Gloria DEL RIO CIDONCHA
Carlos María FERNÁNDEZ PERUCHENA
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Universidad De Sevilla
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Publication of WO2012052582A2 publication Critical patent/WO2012052582A2/fr
Publication of WO2012052582A3 publication Critical patent/WO2012052582A3/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1118—Determining activity level
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16Z—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
    • G16Z99/00—Subject matter not provided for in other main groups of this subclass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1116—Determining posture transitions
    • A61B5/1117—Fall detection
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/50—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders

Definitions

  • the present invention aims at a portable and adaptive multimodal monitoring system for humans, based on a biomechanical-physiological avatar, capable of detecting and warning about physical risk events, which include falls but are not limited to them, in time real, discreetly and in open or closed environments.
  • the system also allows a personalized and deep monitoring of the physical activity of the subject and relevant physiological parameters, in a configurable way and according to the needs established by the healthcare professional.
  • the elderly are a population group with high comorbidity, with primary chronic diseases such as diabetes, chronic renal failure, and cardiovascular disease, among others, and a multitude of chronic degenerative complications, which increases hospital risk and potential complications of a fall, for example of fracture.
  • the fall is a logical event that is activated as a result of the appearance of a sequence of discriminating stages. This sequence of stages is relatively inflexible, and often based on non-programmable hardware elements.
  • the optoelectronic device presented in (Tamura et al, 2000) which generates an alarm event when the subject (device) is sufficiently close to the horizontal position for a set time (a single stage), should be mentioned.
  • the WristCare monitor (Vivatec, www.vivatec.co.uk (last accessed June 2010)) is worn as a wristwatch and detects the lack of activity of the subject (one stage), sending the alarm to a fixed unit in the home .
  • the Intellilink device (Chubb, www.chibcommunitvcare.co.uk (last accessed June 2010)) is a fall detector carried around the neck and also based on a certain inclination change.
  • the algorithm distinguishes a direct detection and a differential detection, in such a way that the direct one is characterized by exceeding the average value of the horizontal axis by ⁇ 3.5 g generating a direct warning (a discrimination stage), and the differential by exceeding ⁇ 1.6 g followed of a period of inactivity (two stages of discrimination).
  • the second type of detectors is characterized by its ability to perform a vector acceleration measurement according to three dimensions (3D), usually orthogonal at the point of fixation, providing flexibility for the kinematic and postural analysis of the user.
  • 3D three dimensions
  • 3D three dimensions
  • this detector uses an accelerometer and algorithms to detect an abrupt change in the pattern followed when walking, and generate a pre-warning, by vibration, that if not deactivated it gives rise to the warning to the center of attention through a fixed station with which it connects wirelessly.
  • Other patents have different technical methods to detect inactivity or present other specific methods for postural or tilt detection, together with some specific sequence of steps to overcome to generate the logical fall event.
  • a characteristic common to almost all devices in the market oriented to the detection of falls in real time is that the detection is done by the same device that makes the capture of the signals, normally based on MEMS accelerometers due to their small size and consumption .
  • An exception to this is the patent (Prado et al, 2002a).
  • Figure 1 Shows a schematic representation of the portable and adaptive multimodal monitor for humans based on biomechanical-physiological avatar for the detection of physical risk events, which is the object of the present invention.
  • the figure illustrates the connection with elements external to the invention by lines (10) and (12).
  • FIG. 1 Shows a simplified block diagram of an intelligent accelerometric sensor, belonging to the monitor's sensor network. In figure 1 two of these sensors are represented by the blocks (1a) and (1 b).
  • Figure 3 It shows a simplified block diagram of a portable transmitter station, which is connected to a SmartPhone via block 24, to provide communication technology with intelligent sensors.
  • the SmartPhone + portable transmitter station set defines the coordinating device of the monitor, represented in figure 1 by the block (2). Description of the invention
  • the present invention aims at a portable and adaptive multimodal monitoring system for humans, based on a biomechanical-physiological avatar, capable of detecting and warning about physical risk events, which include falls but are not limited to them, in time real, discreetly and in open or closed environments.
  • the system also allows a personalized and deep monitoring of the physical activity of the subject and relevant physiological parameters, in a configurable way and according to the needs established by the healthcare professional.
  • the connection between the sensors and the coordinator is reactive to the environment, so that when there is no direct connection between them, the coordinator examines the environment and uses fixed protocol converters to connect to the sensor network, transparently to these last.
  • the coordinating device has functional specifications similar to those of a mobile smart phone, allowing direct connection or via local access unit, with a service provider center. The reactivity to the environment eliminates the need to carry the mobile smart phone when the subject is at home or in another equivalent closed environment.
  • At least the triaxial accelerometer smart sensor can be worn without clothing, either attached to the skin by a hypoallergenic band, on a bracelet, or subject to an ornament of minimum dimensions, and its position can be modified at the user's request to adapt to the changes of band aid or ornament, adapting automatically and in a non-guided way to the new fixing conditions.
  • the invention presents a new system for the detection of physical risk events in humans in real time, including falls, by means of a portable and adaptive multimodal monitor based on a biomechanical-physiological avatar, discreetly, and in open or closed environments.
  • the invention also allows a personalized and deep monitoring of physical activity and physiological parameters relevant to the subject, in a configurable way and according to the needs established by the healthcare professional.
  • the invention is based on the current state of information and communications technologies, microelectromechanical systems, and modeling and simulation techniques of systems in biomedical engineering, and is an innovative contribution in its application to meet the growing needs of remote monitoring in emergency situations and prevention in socio-health care.
  • the system it is constituted by a set of smart and wearable sensors discretely, which are connected to a coordinating device running a physiological biomecánico- avatar of the subject, based on a mathematical model of lumped .
  • the connection between the sensors and the coordinator is made through a wireless network sensitive or reactive to the environment, according to Environmental Intelligence (AmI) concepts.
  • AmI Environmental Intelligence
  • the network behaves like a personal wireless network (WPAN). This is the usual situation when the supervised subject is in an open environment, where he will carry the coordinating device with him, in a bag, belt or similar.
  • the user does not need to carry the coordinating device, so that it can remain on top of its charging base.
  • the coordinator cannot communicate directly with the sensors, automatic switching to a wireless local network (WLAN) occurs, with fixed devices called protocol converters, small size, and distributed regularly in a closed environment. , which act as intermediaries between the sensors and the coordinating device, transparently to the sensors. In this way, the continuous supervision of the subject is guaranteed, both in the home or closed environment that is desired, as in the street, avoiding as much as possible the risk that an unsupervised critical event may occur, as occurs with most the current systems described in the background section.
  • WLAN wireless local network
  • the smart sensors which may be the only in the case of use of the system in its minimum configuration, it is accelerometric.
  • This sensor consists of an accelerometer with MEMS technology and ability to measure static and dynamic accelerations in three dimensions, microcontroller, transceiver, antenna and power supply, In addition to a minimum auxiliary circuitry. All electronic elements use current technology of very low consumption and voltage.
  • This sensor implements an algorithm of impact detection, adaptive and minimum computational cost. The algorithm makes an estimate of the energy accumulated in a temporary window of size smaller than the second, according to claim 3 a , associated with the physical activity of the subject, and dependent on the body position in which it is carried.
  • This estimate is based on a quadratic sum or absolute values of the accelerations captured at the sampling rate used during the indicated time window.
  • the choice of quadratic or absolute values is configurable depending on other pathologies or requirements that the subject may have.
  • it may be relevant to have a more accurate estimate of the energy expenditure measured in a given body position, for example, near the center of gravity of the subject, to enter it as data in the physiological avatar and power Personally predict glucose levels and help predict glycemic events of interest.
  • the estimated energies in each direction are compared with thresholds that in turn are dependent on the subject's own pattern of activity, and on the situation and mode of fixation of the sensor.
  • the calculation of these thresholds is performed by the sensor itself following an adaptive process that addresses the changes in the aforementioned patterns, location and fixation, and are by their nature completely customized.
  • the learning scheme followed is unguided, that is, the subject is not required to perform specific activities.
  • a physical risk pre-event is generated, which will become a physical risk event (EFR), for example a fall, if the energy associated with the three axes of the sensor remains null, with a safety margin, during the seconds following the abovementioned overcoming.
  • EFR physical risk event
  • the thresholds calculated by the sensor can be corrected according to a particular increase or decrease, by the coordinator device.
  • the system is characterized by using a strategy distributed processing "divide and conquer", such that the smart accelerometric sensor that defines the minimum monitor settings handles only the energetic analysis associated with the sampled accelerations at the set frequency, between tens and hundreds of samples per second (S / s), sending the time series of accelerations, with a sampling frequency that may be lower (taking interleaved values), to the coordinating device, when an EFR is activated or when the coordinator expressly requests it.
  • the coordinating device which according to claim 6 a is functionally similar to a SmartPhone, is responsible for kinematic and postural analysis using a biomechanical model with a finite number of degrees of freedom, according to claim 6 a .
  • EFRs Evolved cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase cyclopentase, a stroke, a stroke, a stroke, a stroke, a stroke, a stroke, a stroke, and the like.
  • the intelligent accelerometric sensor has a design capable of detecting EFRs associated with impact through the technique of adaptive energy computing, unguided learning and distributed processing, described above.
  • EFRs not associated with a previous impact which despite their lower frequency can cause significant damage, including fractures and even death, are supervised by the coordinating device, through a periodic analysis of time series of accelerations requested from the sensor, with periods of the order of minutes according to claim 3 a .
  • the coordinating device also performs an analysis of certain EFRs detected by the sensor, periodically or for having been discarded by the user as indicated below, in order to optimize the detection thresholds and improve the specificity of the detection of linked events to impact
  • the system generates a configurable, audible and visible warning, when an EFR has been detected, and both the sensor and the coordinating device allow the deactivation of the EFR shipment detected by the user before being sent to the service provider center.
  • This deactivation can be done by various procedures, including voice recognition, press of a button, etc.
  • the intelligent accelerometric sensor can be carried to the body by a disposable band aid that will change position periodically to prevent dermatitis, adhered to an ornament, or housed in a silicone, neoprene or some waterproof and hypoallergenic polymer wristband.
  • This flexibility is achieved due to the small size of the sensor electronics, with a characteristic diameter around 1 cm, and a height of a fraction of 1 cm.
  • the positional self-calibration in gravitational acceleration, and the unguided learning technique allow to automatically correct the threshold parameters of the EFRs detection algorithm associated with impact, by changing the position of the sensor. This flexibility in the portability of the sensor is a key aspect in its acceptance by users, attending to aspects of (emotional) tastes, ergonomics and personal needs.
  • the coordinating device has functional characteristics equivalent to current mobile smartphones or SmartPhones.
  • this device incorporates a biomechanical mathematical model with a finite number of degrees of freedom that allows the estimation of speeds and accelerations not measured in real time and facilitates the personalized analysis of the kinematics and postures of the subject.
  • This technique is based on the proven ability of these mathematical models for the biomechanical description of humans, and facilitates the distributed and functionally differentiated processing of the time series of signals obtained by the main accelerometric sensor, which characterizes the minimum configuration of the system, as well as of other accelerometric sensors that can increase the accuracy and resolution of the subject's biomechanical information.
  • the current capacity of SmartPhone-type devices allows adding a physiological model of concentrated parameters (property that simplifies the model and reduces the computational cost of execution) to it, according to claim 7 a .
  • This model represents a simplified physiological avatar of the human, particularized or referred to the health parameters defined by the medical professional according to the pathologies that the subject may present, such as the cardiovascular system, the renal system, or the endocrine system.
  • This model can be coupled with the biomechanical if necessary, and acts as a mathematical observer of variables or parameters of difficult measurement, such as real-time blood pressure or vascular volume, which allows to detect emergency health situations on the subject
  • For proper customization and continuous adaptation uses the variables measured by the system's sensor network, as well as data sent from the service provider center, through the coordinating device.
  • the system's sensor network can be programmed using new algorithms during normal device operation. These algorithms are sent from the coordinating device wirelessly, using a methodology similar to that used by the Java code routines called "applets", as indicated in claim 8 a .
  • This function provides a much greater functional flexibility, reducing the cost of updating, and the application of scientific and technological improvements in the processing techniques and in the customization of the sensors, without disturbing the user.
  • the modification of the algorithm and any other sensitive action on the sensors is performed using secure protocols.
  • the accompanying figures present an exemplary embodiment that illustrates, but does not limit, the invention.
  • a device (1) coordinated by a device (2) participates.
  • the device (1) is constituted by two intelligent accelerometric sensors (1a) and (1b) that are carried by the subject in the wrist and waist, by means of some of the fixing systems referred to in claim 5 a
  • the coordinating device (2) is constituted by a SmartPhone connected through a miniUSB port to a portable transmitter station.
  • the communication between the sensors and the coordinating device (2) is carried out by means of a master-slave protocol and the communication technology of the portable transmitter station. This communication is illustrated by lines (8) that join (1a) and (1b) with (2), and define the personal area network (4).
  • the coordinating device (2) When the subject is in his home or equivalent closed environment it is not necessary that the coordinating device (2) be carried by the subject. In that case, the device (2) can leave the range of the personal area network (4), automatically switching to a local area network (5). Under these conditions, the coordinating device (2) maintains the connection with the sensors (1) through the protocol converting devices (3), which are illustrated in this embodiment by blocks (3a) and (3b) .
  • Elements (3a) and (3b) use Bluetooth technology class 1, with a range of 100 meters (approximate), for communication with the coordinating device (2), which in turn will use class 2 or class 1 Bluetooth technology.
  • the Bluetooth communication channel is referred to by the lines (9) in Figure 1.
  • the link between the elements (3) and the sensors is made using the station's communication technology portable transmitter, indicated by the communication lines (8).
  • Communication between the portable multimodal monitor illustrated in Figure 1 and the data processing and service center (6) is carried out both directly through the cellular communication (12) offered by the Smartphone, and through a unit access location (7) through the communication channel (11) that is not defined or limited in the present embodiment as there are many options available.
  • the device (2) is connected to the unit (7) via Bluetooth in this example. In this way this unit (7) is considered to belong to the local area network (5), although it does not belong to the proposed multimodal monitor.
  • the intelligent accelerometric sensors (1a) and (1b) correspond to the block diagram in Figure 2. These consist of an integrated circuit (15) of the System-On-Chip (SoC) type of 5 x 5 x 0.8 mm that includes a 8-bit microprocessor (13) with peripherals (SPI, UART, programmable GPIO ports) and memory (RAM and ROM), and an integrated transceiver (14) for the frequency band of industrial, scientific and medical devices (ICM, 862 - 870 MHz for Europe), FSK and GFSK modulation, data rate of up to 50 kbps, error rate of less than 0.1%, and an operating consumption of less than 5 mW.
  • SoC System-On-Chip
  • the SoC (15) is configured as a slave in its use in the intelligent accelerometric sensor, and is powered at a voltage of 1.4 v provided by the Zinc button battery (18).
  • a DC-DC converter (19) 3 x 3 x 0.9 mm step-up type is used to provide the 3 v voltage required by the triaxial accelerometer (17).
  • the latter is a capacitive accelerometer, 2 x 2 x 0.95 mm, with measuring range of up to 8g, output of signals sampled by SPI and internal operating logic capable of generating interruptions to the element (15) if it detects conditions of acceleration (magnitude and time) established.
  • the smart sensor uses an antenna (16) with multilayer ceramic technology, omnidirectional, for the indicated ICM frequency band, and dimensions 7 x 2 x 0.8 mm.
  • Figure 3 presents a simplified block diagram of the station portable transmission, which consists of a SoC (22), which includes a microcontroller (20) and transceiver (21), identical to that used in smart sensors ( Figure 2).
  • the required voltage per block 22 is provided by block (24), which includes auxiliary circuitry for USB connection and a DC-DC converter.
  • the antenna of similar characteristics to that of the intelligent sensor, is indicated by the block (23), but unlike that one, more directive solutions, greater gain, and of a somewhat larger size can be used in the interface, due to the requirements less size restrictive, both in the version linked to the Smartphone, and (especially) in the version used for protocol converters.
  • the mode of operation of the system responds to the distributed technique and with functional division between sensors (1) and coordinating device (2), as indicated in the detailed description.
  • the system does not require that the sensors have a fixed body orientation.
  • the sensor (1b) fixed to the skin by a hypoallergenic band, at the waist (side or back) computes the energy associated with physical activity on each axis as the sum of the quadratic accelerations with a frequency of 100 S / s, over a temporary window 500 ms wide.
  • the sensor (1a) worn on the wrist, estimates the energy associated with the physical energy in each axis as the sum of the accelerations in absolute value with a frequency of 400 S / s on a window of 600 ms.
  • Both sensors can detect EFRs, but in this embodiment it is only necessary to carry the (1a), while the (1b) provides additional information to feed a physiological avatar about (2) capable of describing the dynamics of the glucose system - insulin using a mathematical model of concentrated parameters. This avatar is used to optimize the therapeutic strategy of insulin administration in a patient with type 2 diabetes mellitus.
  • the smart sensor (1 b) needs to be taken 24 hours a day, unlike the sensor (1a), which is used as the sensor that defines the minimum mode of the monitor, according to claim 2 a .
  • the unguided learning technique implemented in the sensors calculates and adapts the energy thresholds on each axis, making them equal to the maximum of the average temporal energy of activities not linked to an impact (that is, without exceeding thresholds), making the average over a 10-second time window, and discarding zero energy zones (rest).

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Abstract

La présente invention concerne un système de monitorage multimodal portable, conçu pour des êtres humains, basé sur un avatar biomécanico-physiologique, capable de détecter et de prévenir des événements physiques à risque qui comprennent des chutes mais ne se limitent pas à celles-ci, et ce en temps réel, de manière discrète et dans des environnements ouverts ou fermés. Le système permet en outre un suivi personnalisé et approfondi de l'activité physique du patient et des paramètres physiologiques pertinents, d'une manière configurable et en accord avec les nécessités établies par le professionnel de la santé.
PCT/ES2011/000311 2010-10-22 2011-10-21 Moniteur multimodal portable, conçu pour des êtres humains, basé sur un avatar biomécanico-physiologique pour la détection d'événements physiques à risque WO2012052582A2 (fr)

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ESP201001372 2010-10-22
ES201001372A ES2394842B1 (es) 2010-10-22 2010-10-22 Monitor multimodal portable y adaptativo para humanos basado en avatar biomecánico-fisiológico para la detección de eventos fisicos de riesgo.

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US9313646B2 (en) 2013-10-17 2016-04-12 At&T Intellectual Property I, Lp Method and apparatus for adjusting device persona
US10419921B2 (en) 2013-10-17 2019-09-17 At&T Intellectual Property I, L.P. Method and apparatus for adjusting device persona
US10812965B2 (en) 2013-10-17 2020-10-20 At&T Intellectual Property I, L.P. Method and apparatus for adjusting device persona
US10311482B2 (en) 2013-11-11 2019-06-04 At&T Intellectual Property I, Lp Method and apparatus for adjusting a digital assistant persona
US11227312B2 (en) 2013-11-11 2022-01-18 At&T Intellectual Property I, L.P. Method and apparatus for adjusting a digital assistant persona
US11676176B2 (en) 2013-11-11 2023-06-13 At&T Intellectual Property I, L.P. Method and apparatus for adjusting a digital assistant persona

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